title: Selective embolization with N-butyl cyanoacrylate for metastatic bone disease.
abstract: OBJECTIVE
  To evaluate the clinical and imaging effect of selective embolization using N-butyl cyanoacrylate (NBCA) as palliation for bone metastases.
  
  
  METHODS
  The procedures and effect of 309 embolizations performed in 243 patients were retrospectively analyzed; 56 patients had repeat embolization at the same location at 1-3 months; 197 patients had embolization for progressive bone metastases after radiation therapy. The mean tumor diameter before embolization was 7.8 cm (range 5-30 cm). In all patients, embolizations were performed under local anesthesia through transfemoral catheterization using NBCA in 33% ethiodized oil. The technical success of embolization was evaluated by angiography after completion of the procedure. The clinical and imaging effect was evaluated at follow-up examinations with a pain score scale and use of analgesics, hypoattenuating areas, tumor size, and ossification.
  
  
  RESULTS
  In all 309 embolizations, postprocedural angiography showed complete occlusion of metastatic blood supply and greater than 80% devascularization of the lesions. Greater than 50% reduction of pain score and analgesic doses was achieved in 97% of procedures. The mean duration of pain relief was 8.1 months (range 1-12 months). The mean maximal tumor diameter after embolization was 5.5 cm (range 2-20 cm). Variable ossification appeared in 65 patients. Postembolization syndrome, ischemic pain at the site of embolization, paresthesias, skin breakdown, and subcutaneous necrosis were observed in 87 patients.
  
  
  CONCLUSIONS
  Selective embolization with NBCA is a safe and effective palliative treatment for metastatic bone lesions of various primary cancers; pain relief is temporary.
authors.affiliation: Department of Interventional Angiographic Radiology, Istituto Ortopedico Rizzoli, Bologna, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Rossi
authors.forename: Andreas F
authors.initials: AF
authors.lastname: Mavrogenis
authors.forename: Eugenio
authors.initials: E
authors.lastname: Rimondi
authors.forename: Lucia
authors.initials: L
authors.lastname: Braccaioli
authors.forename: Teresa
authors.initials: T
authors.lastname: Calabrò
authors.forename: Pietro
authors.initials: P
authors.lastname: Ruggieri
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D001859:Bone Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000556:secondary / Q000628:therapy*; D018450:Disease Progression; D004621:Embolization, Therapeutic / Q000009:adverse effects; D004659:Enbucrilate / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010148:Intractable Pain / Q000209:etiology / Q000628:therapy; D010166:Palliative Care; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D004659:Enbucrilate